Recovering from ACL Reconstruction
ACL reconstruction comes with a low risk of complication, but recovery takes time, and it’s important to know signs of trouble. Following your doctor’s instructions carefully will help you achieve the best outcomes as you heal. Here’s a look at what you should know.
- First Postoperative Day
- Nausea and Pain Medication
- Complications: When to Get Help
- Recovering from ACL Surgery
- More Information
First Postoperative Day
The day following surgery may be a lot tougher than the day of surgery. The numbing medicines used during surgery will wear off and there may be more pain. Your doctor will most likely have prescribed a CPM (continuous passive movement) machine. Try and use the CPM machine as much as possible while increasing the CPM range of motion as pain dictates. Ice bags or the ice machine should be used continuously. The leg should be elevated as much as possible above the heart. Try to do as little activity as possible and take your pain medication regularly. Do not get behind your pain, or it may get quite severe.
It is normal for bloody drainage to appear on the outer bandages. The drainage is mostly absorbed water mixed with small amounts of blood. The bandage should be shifted slightly so that dry bandage covers the draining portal. You can also place new bandages around the knee.
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Nausea and Pain Medication
Surgery is not painless. Try to take your pain pills as directed even before you experience pain. Nausea and vomiting are very common postoperative problems. If you start to get nauseated, try and minimize the use of the codeine pain medication if prescribed (hydrocodone or vicodin) and use Tylenol and Motrin for pain control. (Codeine products can make you nauseated.) Start eating more slowly beginning with soup and crackers. If you're prone to nausea, ask for anti-nausea medication prior to surgery.
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Complications: When to Get Help
Signs of infection include redness around the incision area, discharge of pus from the wound, increased pain and a fever of more than 101 degrees with chills and/or sweating. You will want to keep your doctor abreast of any changes.
Blood clots (thrombophlibitis) can occur after arthroscopic knee surgery. Usually, but not always, they occur in individuals with risks such as people who are more than 50 years of age, smoke or are overweight. Signs of blood clots include increased calf pain and the inability to put weight on the leg due to pain, as well redness and swelling of the calf.
If you experience pain in your back or shortness of breath, call 911 immediately. If you are concerned but do not feel it is an emergency, please call your doctor’s office immediately.
Risk of Graft Failure
The signs of a graft not forming a blood supply and weakening are not obvious. However, they are usually discovered during the postoperative evaluations.
Loss of Motion
After surgery, it is very important to obtain and maintain full extension (getting the leg as straight as the nonsurgical leg).
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Recovering from ACL Surgery
The weeks following ACL reconstruction surgery will be somewhat difficult but also rewarding. It is important to follow your doctor’s instructions. In general, listen to your body. Your first goal is to regain full extension (straightening the knee) and prevent postoperative complications such as infection, blood clots and stiffness.
You can begin putting weight on the leg while it is in the brace and using crutches until you are stable walking without them. Generally, it is best to stop using the crutches first and walk with your leg in the brace. The brace can be removed when you know you will not slip or fall. Usually, the only way to hurt an ACL graft is to slip suddenly or fall.
Most patients go to physical therapy three times per week, but exercises should be performed daily. The more you work without increasing your pain or swelling, the faster you will recover. Some patients are off their crutches in a few days and out of the brace within a week, biking in 10 days and able to jog in six weeks; some may take up to six months.
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This information provided by Dr. Warren King, M.D., director of the Sports Medicine Fellowship Program at Sutter Health’s Palo Alto Medical Foundation.